Objective：To explore the diagnosis and treatment of extensive portal venous system thrombosis.
Methods：The clinical data of 10 cases of extensive portal venous system thrombosis were analyzed retrospectively.
Results：Two cases were misdiagnosed and underwent exploratory laparotomy. The diagnosis was established in 8 patients by imaging angiography and selective superior mesenteric arteriography. Four patients were treated with emergency operation and five patients underwent thrombolytic therapy (two cases of thses were converted to open intestinal resection because of intestinal necrosis); 1 patient received thrombolytic therapy through peripheral vein. Six patients survived and 4 died. Six survivors were treated with long-term warfarin therapy. In 0.5-6 y follow-up for the six survivors, one developed short bowel syndrome, one had recurrence and another deveolped adhesive intestinal obstruction.
Conclusions：Extensive portal venous system thrombosis is very easy to be misdiagnosed. Imaging examination and selective angiography are of great importance for early diagnosis. Early treatment is pivotal to its prognosis.